Employee Benefits - Central Web Server 2web2.uconn.edu/hrnew/docs/benefits_pres_071515.pdf · Pharmacy Benefits through Caremark For ... – J1 or F1 visa holders State Employees

Employee Benefits

Department of Human Resources

Medical Options


Point of Enrollment-Gated (POE-G)− Network-based care only except in

emergencies− Primary care physician referrals required

Point-of-Enrollment (POE)− Network-based care only except in

emergencies− No referrals to specialists required

Point-of-Service (POS)− In-Network− Out-of-Network: $300/person

deductible, 80/20 coinsurance− Emergencies covered as in-network

Medical Insurance Carriers


o Regional network: CT, MA, RIo Nationwide access

o Regional network: CT, NJ, NY (Oxford network, not UnitedHealthcare)

o Nationwide access: UnitedHealthcare network (outside of CT, NJ, NY)

Note: You must live or work within a plan’s regional service area to enroll in that plan – even though the plan has a national network

Medical Biweekly Paycheck Deductions


BIWEEKLY DEDUCTIONS FOR EMPLOYEES ON REGULAR PAYROLL

July 1, 2015 – June 30, 2016

Empl Only Empl + 1 Family FLES*

Point-of-Enrollment – Gated (POE-G)

Anthem State BlueCare POE Plus $26.81 $ 77.54 $ 99.63 $ 52.14

United Healthcare Oxford HMO $20.26 $ 58.01 $ 74.53 $ 39.00

Point-of-Enrollment (POE)

Anthem State BlueCare $29.45 $ 88.73 $118.10 $ 59.28

United Healthcare Oxford HMO Select $23.76 $ 71.59 $ 95.28 $ 47.82

Point-of-Service (POS)

Anthem State BlueCare $ 37.93 $131.05 $151.40 $ 67.90

United Healthcare Oxford Freedom Select $ 31.09 $107.42 $124.11 $ 55.66

Out of Area Point-of-Service (POS)

(non-CT residents only)

Anthem State Preferred $ 37.93 $131.05 $151.40 $ 67.90

United Healthcare Oxford USA $ 31.09 $107.42 $124.11 $ 55.66

*Family Less Employed Spouse (FLES) rate is available only when both spouses are employed by the State of Connecticut, eligible for health insurance, and enrolled in the same plan, along with at least one child.

Health Enhancement Program (HEP)


• Key components• Preventive physical examinations• Preventive screenings• Disease counseling and education programs

• Election covers employees and covered family members

• Financial incentives to participate• Copayment waived for physicals• Two free dental cleanings per year, plus no limit on periodontal care (for covered members enrolled in

dental)• Disease management: waived office visit copays, reduced prescription drug copays, $100 compliance

payment

• Financial disincentive for non-participation/non-compliance• $100/month premium• $350 per person annual deductible ($1,400 family max)

• Participants who are non-compliant • Given appropriate notice and opportunity to improve• Ineligible to re-enroll until start of following month

2015 HEP Preventive Care RequirementsPreventive Service

Birth –Age 5

Age 6 - 17 Age 18 - 24 Age 25 - 29 Age 30 - 39 Age 40 - 49 Age 50+

Preventive Visit 1 per year 1 every other year

Every 3 years Every 3 years Every 3 years Every 2 years Every year

Vision Exam N/A N/A Every 7 years Every 7 years Every 7 years Every 4 years Age 50-64: Every 3 yearsAge 65+: Every 2 years

Dental Cleanings*

N/A At least 1 per year

At least 1 per year

At least 1 per year

At least 1 per year

At least 1 per year

At least 1 per year

CholesterolScreening

N/A N/A Every 5 years (20+)

Every 5 years Every 3 years Every 2 years Every year

Breast Cancer Screening (Mammogram)

N/A N/A N/A N/A 1 screening between age 35 - 39**

As recommendedby Physician

As recommended by Physician

Cervical Cancer Screening (Pap Smear)

N/A N/A Every 3 years (21+)

Every 3 years Every 3 years Every 3 years Every 3 years

Colorectal Cancer Screening

N/A N/A N/A N/A N/A N/A Colonoscopy every 10 years or Annual FIT/FOBT

*Dental cleanings are required for family members who are participating in one of the State dental plans**Or as recommended by your physician


Financial incentive: office visit copayments waived/rebated

HEP-Counseling, Education & Incentives


• Disease Counseling and Education Programs Diabetes, both Type 1 and 2 Asthma and COPD Heart failure/heart disease Hyperlipidemia Hypertension

• Health Care Counselor –• Explains current strategies to control the disease, provides written

materials and info about online resources

• Financial incentives• Office visit copayments waived/rebated• Prescription drug copayments reduced: $0/5/12.50 (waived for drugs

prescribed for diabetes)• $100 cash payment for compliance in disease management program

Pharmacy Benefits through CaremarkFor… Maintenance Drugs

90-Day SupplyNon-Maintenance Drugs 30-Day Supply

Tier 1: Generic drug $5 $5

Tier 2: Preferred brand-name drug

$10 $20

Tier 3: Non-preferred brand-name drug

$25 ($10 if your physician certifies the non-preferred brand-name drug is medically necessary)

$35 ($20 if your physician certifies the non-preferred brand-name drug is medically necessary)

Where filled First 30-day fill can be at any participating pharmacy. After that, choice:• Caremark mail order pharmacy• Pharmacy that participates in

State’s Maintenance Drug Network

Participating pharmacies


Note: Copays for medications to treat chronic conditions under the HEP program:• Tier I (generic): $0• Tier 2 (preferred): $5• Tier 3 (non-preferred): $12.50• $0 for medications and supplies to treat diabetes (Type 1 and Type 2)

Dental Options through CIGNABasic Plan (any dentist)

Enhanced Plan(network)

DHMO(network only)

Annual Deductible None $25/individual, $75/family None

Annual Maximum None ($500 per person for Periodontics)

$3,000 per person (excluding orthodontics)

None

Exams, Cleanings, and X-rays Covered at 100% Covered at 100%1 Covered at 100%

Periodontal Maintenance Covered at 80%2 Covered at 100%2 Covered3

Simple Restoration

- Fillings- Oral Surgery

Covered at 80%Covered at 67%

Covered at 80%Covered at 80%

Covered3

Covered3

Major Restoration

- Crowns- Dentures, Fixed Bridges- Implants

Covered at 67%Not covered4

Not covered4

Covered at 67%Covered at 50%Covered at 50% (up to $500)

Covered3

Covered3

Not covered

Orthodontia Not covered Plan pays $1,500 per person per lifetime Covered3


1 If using out-of-network dentists, you will be subject to balance billing if your dentist charges more than the maximum allowable charge2 If enrolled in HEP: No annual maximum on services for periodontal maintenance (2 per calendar year) or scaling and root planing3 Contact CIGNA for patient co-pay amounts4 While not covered, you will get the discounted rate on these services if you visit a network dentist, unless prohibited by state law

Dental Biweekly Payroll Deductions

BIWEEKLY DEDUCTIONS FOR EMPLOYEES ON REGULAR PAYROLL

July 1, 2015 – June 30, 2016

Employee Only Employee + 1 Family

Enhanced

DHMO

$ 0.00 $ 13.94 $ 13.94

$ 0.00 $ 11.94 $ 11.94

$ 0.00 $ 4.55 $ 6.45

*Family Less Employed Spouse (FLES) rate is available only when both spouses are employed by the State of Connecticut, eligible for health insurance, and enrolled in the same plan, along with at least one child.

11:00 AM - 11:30 AM

BenefitsDepartment of Human Resources

FLES*

$ 7.14

$ 6.12

$ 2.65

Basic

Medical & Dental Information


Eligible Dependents

− Spouse (including same-sex), or party to a civil union

− Dependent children

• Medical to age 26

• Dental to age 19

• No age limit if disabled

Effective Date

− First of month following hire date/transfer

Changing Your Elections− Open enrollment: effective July 1 each year− Qualifying status change

Life Insurance


• Basic Life Insurance (Contributory plan)

• Supplemental Life Insurance (Employee pay all)

– Available to AAUP, UCPEA, Managerial/Confidential, Postdoctoral Fellows and Law School faculty with annual earnings of $45,500 or more

• Administered by Dearborn National

• No evidence of good health required if you enroll within 31 days of hire

• Effective date is six months following hire date

• Continue a reduced amount of life insurance in retirement at no cost

Retirement Plans


Employees Ineligible for Retirement Plan

– Postdoctoral Fellows

– J1 or F1 visa holders

State Employees Retirement System (SERS) Tier III

− Defined benefit plan

− Based on years of service and salary

− Employee contributes 2% (hazardous duty employees contribute 5%)

− Vesting: 10 years service

Options available to AAUP, UCPEA, Managerial/Confidential, Law School Faculty in lieu of SERS

− Alternate Retirement Program (ARP)− Hybrid Plan

Retirement Plans


Alternate Retirement Program (ARP)

– Defined contribution plan

– Employee contributes 5%, State contributes 8% (total 13%)

– Employee directs how monies are invested

– Vesting: immediate

– Administered through Prudential

Hybrid Plan

– Defined benefit plan

– Employee contributes 5%

– Vesting: 10 years service

– Upon retirement, vested employees have a choice:

• SERS benefit

• Cash out option: employee contributions, matched by employer, plus 4% interest

Retirement Choice


Employees with choice have 60 days following hire date to make their election

Decision is irrevocable

Long Term Disability insurance plan automatically provided to ARP participants

Retiree Health Benefits


Employees contribute 3% of pay for first 10 years of state service

• Only employees with vested retiree health benefits from former employer can waive coverage and contributions

Vested in retiree health benefits after 15 years of actual state service

• Retiree health benefits available at retirement

• For employees who leave prior to early or normal retirement, retiree health insurance commences when age and service equals 75 or more

Employees who leave state service prior to 15 years can request a refund of contributions

Additional Benefits


Life Insurance

– Term life insurance through Dearborn National

– Aetna Universal Life Insurance

– VOYA Universal Life Insurance

Retirement Savings: 403(b), 457, Roth 403(b), Roth 457 through

Long Term Disability through Aetna (for employees enrolled in SERS or Hybrid)

Short Term Disability

– The Hartford (for employees enrolled in ARP)

– Colonial Supplemental Insurance Company

– Dearborn National

Additional Benefits


Flexible Spending Accounts

– Dependent Care Assistance Program

– MEDFLEX

Qualified Transportation Account

Long Term Care

Auto and Homeowner Insurance

– Metropolitan Casualty & Property Insurance Company & Affiliates

– Liberty Mutual Insurance Company

– Travelers

WorkLife Resources


Work/Life Connections website

Employee Assistance Program (EAP)

Complete Forms by Deadline


Personalized enrollment form will be emailed to you at your uconn.edu address:

─ Medical election─ Dental election─ Life Insurance election

The email will include a link to the e-Forms packet on the HR website:

─ Employee Information and Change Form─ Equal Employment Opportunity Information Sheet─ Voluntary Self-Identification of Disability─ Retiree Health Fund Enrollment Form─ Health Enhancement Program Enrollment─ Designation of Retirement System-Tier-Plan-Beneficiary─ Retirement Credit Purchase Request for Prior Miscellaneous

Service

Form Submission & Verification


• Original forms can be mailed or delivered in person and should include copies of proof documents

• Option to schedule appointment with a Benefits Representative

• Review Confirmation Report

– Mailed within two weeks following receipt of completed paperwork

• Look for Medical/Pharmacy/Dental ID cards

– Mailed within 30 days following receipt of completed paperwork

• Verify accuracy of payroll deductions

Documents

Employee Benefits - Central Web Server 2web2.uconn.edu/hrnew/docs/benefits_pres_071515.pdf · Pharmacy Benefits through Caremark For ... – J1 or F1 visa holders State Employees